Determinants of antenatal care use in Ghana created by G.B. Overbosch, N.N.N. Nsowah-Nuamah, G.J.M. van den Boom and L. Damnyag

The paper investigates the determinants of antenatal care use in Ghana. In particular, we study how economic factors affect the demand for antenatal care and the probability that the number of visits falls below the recommended number of four. Estimation results from a nested three-level multinomial logit model (care or no care; doctor or nurse or midwife; sufficient or insufficient visits) show that indeed living standard, cost of consultation and in particular travel distance to the provider have a significant impact on the demand and sufficiency of antenatal care. In addition, pregnant women with more schooling have a higher propensity to seek sufficient antenatal care from all providers, while women of higher parity tend to use less antenatal care from less expensive providers. These results suggest that adequate antenatal care use in Ghana can be promoted effectively by extending the supply of antenatal care services in the rural area, by general education policies and by specific policies that increase reproductive health knowledge. Furthermore, contrary to findings elsewhere, our estimates provide little support for a special targeting of antenatal care according to religious background.